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Surgical Supplies and Instruments
Chapter 56
Copyright © 2011, 2007, 2003, 1999 by Saunders, an imprint of Elsevier Inc. All rights reserved.
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Learning Objectives
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Define, spell, and pronounce the terms listed
in the vocabulary.
Apply critical thinking skills in performing
patient assessment and care.
Describe typical solutions and medications
used in minor surgical procedures.
Summarize methods for identifying surgical
instruments used in minor office surgery.
Outline the general classifications of surgical
instruments.
Copyright © 2011, 2007, 2003, 1999 by Saunders, an imprint of Elsevier Inc. All rights reserved.
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Learning Objectives
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Describe the care of surgical instruments.
Identify types of sutures and surgical
needles.
Describe the medical assistant's need to be
aware of patient concerns regarding patient
perception of procedures.
Copyright © 2011, 2007, 2003, 1999 by Saunders, an imprint of Elsevier Inc. All rights reserved.
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Office Surgery
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Restricted to the management of minor
problems and injuries
Medical assistant’s duties:
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prepare the patient and the sterile field
assist the physician as needed
take care of the patient after the procedure
properly disinfect the area
document as needed
Copyright © 2011, 2007, 2003, 1999 by Saunders, an imprint of Elsevier Inc. All rights reserved.
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Minor Surgery Room
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Near a workroom with a sink and an autoclave
Easy to disinfect and uncluttered
Operating table, a clock with a second sweep,
an operating light, sitting stools, and Mayo
stands
Cabinets with countertops
Copyright © 2011, 2007, 2003, 1999 by Saunders, an imprint of Elsevier Inc. All rights reserved.
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Minor Surgery Room
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Surgical Solutions and Medications
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The solutions used in minor surgery include:
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Sterile water
 Sterile saline
 Antiseptic skin cleansers such as povidone-iodine
(Betadine) or chlorhexidine (Hibiclens)
 Local anesthetics including ethyl chloride or
fluoromethane
Copyright © 2011, 2007, 2003, 1999 by Saunders, an imprint of Elsevier Inc. All rights reserved.
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Additional Surgical Supplies
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Wound drains to drain excess fluid
Sterilized gauze squares or strips saturated
with petroleum jelly for packing wounds
Sterilized iodoform gauze strips used to pack
abscesses, acting as a wick to draw out the
infection and as a local antibacterial agent
Surgical sponges to absorb blood and protect
tissues during surgery
Syringes and needles to inject local
anesthetics and irrigate wounds
Copyright © 2011, 2007, 2003, 1999 by Saunders, an imprint of Elsevier Inc. All rights reserved.
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Local Anesthetics
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Topical applications
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Local anesthetic either sprayed or injected at the
site
Local anesthetics may come packaged with or
without epinephrine. The physician may use
topical silver nitrate to control local bleeding.
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Lidocaine, chloroprocaine (Nescaine), or
bupivacaine (Sensorcaine) injectables
Copyright © 2011, 2007, 2003, 1999 by Saunders, an imprint of Elsevier Inc. All rights reserved.
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Critical Thinking Application
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Tom is ready to do an inventory of supplies in
the minor surgery room. What solutions,
medications, and miscellaneous supplies
should he make sure are on hand for the
busy surgical schedule planned for next
week?
Copyright © 2011, 2007, 2003, 1999 by Saunders, an imprint of Elsevier Inc. All rights reserved.
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Surgical Instruments
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Surgical instruments are classified according to
their use: cutting, grasping, retracting, probing, or
dilating tools.
The components include the type of handle, the
closing mechanism, and the jaws. Instrument tips
may be either straight or curved, sharp or blunt.
Surgical instruments are expensive and must be
cared for properly. Examine instruments when
purchased for proper working order and possible
faults with mechanisms. Keep stainless steel
instruments separate from other metal types.
Copyright © 2011, 2007, 2003, 1999 by Saunders, an imprint of Elsevier Inc. All rights reserved.
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Cleaning
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Each instrument must be cleaned according to
the manufacturer’s guidelines, unlocked, and
disinfected immediately after use. Some
instruments must be washed by hand in a mild,
neutral pH solution with a soft brush.
Most instruments can be cleaned with an
ultrasonic washer. This prevents possible injury
with sharp instruments.
Copyright © 2011, 2007, 2003, 1999 by Saunders, an imprint of Elsevier Inc. All rights reserved.
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Instrument Types
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Instruments used in minor surgical procedures
are dependent on the type of procedure and
physician preference.
Basic components are the handle, closing
mechanism, and part that contacts the patient
(jaws).
Have either ring or spring handles; box-lock
handles can lock in place with ratchets.
Copyright © 2011, 2007, 2003, 1999 by Saunders, an imprint of Elsevier Inc. All rights reserved.
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Instrument Types
Copyright © 2011, 2007, 2003, 1999 by Saunders, an imprint of Elsevier Inc. All rights reserved.
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Instrument Types
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Inner surface of jaws may be serrated.
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Instrument tips or jaws may have teeth.
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Instrument is typically named for its use or after
the person who developed it.
Copyright © 2011, 2007, 2003, 1999 by Saunders, an imprint of Elsevier Inc. All rights reserved.
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Instrument Types
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Disposable Scalpels
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Copyright © 2011, 2007, 2003, 1999 by Saunders, an imprint of Elsevier Inc. All rights reserved.
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Retractors
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Senn retractor
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Probes and Dilators
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Probes
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Critical Thinking Application
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Tom is preparing instrument and supply
packs for specific procedures performed by
Dr. Samanski. One of the packs he is
preparing for the autoclave is for removal of a
nasal polyp. Based on your understanding of
typical and specialty instruments and
supplies, what items should Tom include in
the instrument pack?
Copyright © 2011, 2007, 2003, 1999 by Saunders, an imprint of Elsevier Inc. All rights reserved.
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Critical Thinking Application
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Tom is responsible for inspecting and caring
for all of the surgical instruments in the minor
surgical room as well as cleaning and
preparing contaminated instruments for
autoclaving. He is in the process of writing an
addition to the office policies and procedures
manual on the management of surgical
instruments. Based on what you know about
the care and handling of surgical instruments,
what should Tom include in the policy?
Copyright © 2011, 2007, 2003, 1999 by Saunders, an imprint of Elsevier Inc. All rights reserved.
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Sutures
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Sutures are either absorbable or nonabsorbable.
Absorbable sutures are used internally and are
dissolved over time by body enzymes, and
nonabsorbable sutures are on the wound surface
and left in place until the site is healed.
Catgut and Vicryl are absorbable materials, whereas
nonabsorbable sutures can be made of silk, nylon, or
staples.
Suture materials range from smaller gauges for finer
tissues below 0 (aught) to thicker gauges above 0.
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11-0 are thinnest, and 7 are thickest
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Sutures
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Suture Size
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Sutures are sized according to the USP scale.
Sizes and diameters are available on a scale
from 6 to 0, which is 0.07 mm in diameter, to 2,
which is 0.5 mm:
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6-0 = 0.07 mm
 5-0 = 0.10 mm
 4-0 = 0.15 mm
 3-0 = 0.20 mm
 2-0 = 0.30 mm
 0 = 0.35 mm
 1 = 0.40 mm
 2 = 0.5 mm
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Needles
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Surgical needles are either straight or curved:
the sharper the curve, the deeper the surgeon
can pass the needle.
Most needles are swaged—manufactured with
the suture material attached. The medical
assistant must ask the physician for his or her
preference.
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Needles
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Patient Education
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Patients may have questions concerning the
instruments the surgeon is using.
The medical assistant can assist the patient by
answering his or her questions to help alleviate
any fears.
Explaining patient preparation for the
procedure, how it will be conducted, and what
to expect afterward helps make the procedure
easier to perform and encourages the patient
to follow the physician’s advice and orders.
Copyright © 2011, 2007, 2003, 1999 by Saunders, an imprint of Elsevier Inc. All rights reserved.
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